Surgical Outcomes of Superotemporal Versus Inferonasal Placement of Aurolab Aqueous Drainage Implant in Refractory Pediatric Glaucoma
| Autor: | Iswarya Mani, Subbaiah Ramasamy Krishnadas, George Varghese Puthuran, Hiruni Kaushalya Wijesinghe, Paul F. Palmberg, Steven J. Gedde, Alan L. Robin, Kousalya Pavani Chiranjeevi |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Reoperation Intraocular pressure medicine.medical_specialty Adolescent genetic structures Visual Acuity Glaucoma Prosthesis Implantation Tonometry Ocular 03 medical and health sciences Quadrant (abdomen) 0302 clinical medicine medicine Humans Child Glaucoma Drainage Implants Intraocular Pressure Retrospective Studies 030304 developmental biology 0303 health sciences business.industry Infant Retrospective cohort study medicine.disease eye diseases Confidence interval Surgery Ophthalmology Treatment Outcome Child Preschool 030221 ophthalmology & optometry Female Pediatric glaucoma sense organs Implant Complication business Follow-Up Studies |
| Zdroj: | American Journal of Ophthalmology. 224:102-111 |
| ISSN: | 0002-9394 |
| Popis: | Purpose We sought to describe the outcomes of the Aurolab aqueous drainage implant (AADI) placed in the superotemporal (ST) versus the inferonasal (IN) quadrant in pediatric eyes with refractory glaucoma. Design Retrospective comparative interventional case series. Methods This was a retrospective study of patients ≤18 years of age who underwent AADI implantation and completed a minimum of 2-year follow-up. The choice of the quadrant depended upon the amount of scarring and conjunctival mobility. Cumulative success at 2 years was defined as intraocular pressure (IOP) ≤21 mm Hg or reduced by ≥20% below baseline on 2 consecutive follow-up visits after 3 months, IOP ≤5 mm Hg on 2 consecutive follow-up visits after 3 months, reoperation for glaucoma or a complication, or loss of light perception vision. Results A total of 144 patients (144 eyes) underwent AADI placement, including 48 eyes (33%) in the IN and 96 eyes (67%) in the ST quadrants. The IOP was significantly higher in the IN group (17.5 ± 7.4 mm Hg vs 13.7 ± 6.2 mm Hg, P = .005) with a greater number of medications (1.5 ± 1.0 vs 0.8 ± 0.9, P = .001) after 2 years of follow-up. Cumulative success rates at 2 years were 50.7% (95% confidence interval 35.4%-63.9%) in the IN group and 65.6% (95% confidence interval 56.5%-75.7%) in the ST group (P = .15). Complications occurred more frequently in the IN group, with significantly more tube exposure (12% vs 0%, P = .05). Conclusions Placement of the AADI in the ST quadrant has better IOP-related outcomes and is a safer surgical option in pediatric eyes compared with the IN quadrant. It may be prudent to avoid AADI in the IN quadrant in children unless the ST location is not a viable option. |
| Databáze: | OpenAIRE |
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